| NPI | 1407058530 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0003X Internal Medicine, Hematology & Oncology (Licence: TX P7920) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD431936) |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: FL ME101878) | |
| 207RH0003X Internal Medicine, Hematology & Oncology (Licence: ND 12008) | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2013-10-31 |